University of Toronto

October 21, 2020.

Myanmar is undergoing a transition from military to civilian rule since 2011 and government expenditure on health has increased from 1% in 2010 to 3.4% in 2015, still one of the lowest in the Asia-Pacific region. Though health sector decentralization is said to be put in place, the progress so far has not been assessed. There is limited information on how resources are managed and how well is decentralization progressing. The current system favors top-down decision-making, creating vast gaps of expectations between decision-makers and communities in states/regions, townships and villages/wards. In ethnic states, the delivery of health service remains unequal and insufficient due to poor governance, limited budgets, outdated facilities, and lack of supplies and health staff. Moreover, in such resource-poor setting, the gap between community expectations and what service providers can actually offer remains enormous, and needs to be closed.